Diabetes is one of the most serious health threats in the islands today. It is now the main cause of death in Kosrae and in the Marshalls, the number two cause of death in Pohnpei, and the number three cause of death in Chuuk. It is rampant in other parts of Micronesia as well. Even apart from the deaths it causes, the disease has crippled and blinded many islanders.

About one out of every five middle-aged Micronesians suffers from this disease. In some places, particularly Kosrae and the Marshalls, the diabetes rate is much higher, with as many as a third or a half of all older people suffering from the disease. This is far higher than the rate in the US or other countries around the world. Micronesians seem to be especially susceptible to the disease. What is even worse, diabetes appears to be on the rise.

What Is Diabetes?

Diabetes is called a non-communicable disease–that is, one that can not be spread from one person to another. It is a disease that takes many years to develop. Diabetes is a defect in the way that our bodies process sugar, impairing the removal of sugar from the bloodstream. Sugar and carbohydrates (rice, breadfruit, taro and other starches) are a major source of energy for the body, but too much of them is a danger to our health. High levels of sugar in our bloodstream increases the risk of heart attack and stroke and can cause kidney disease. In fact, an excessive sugar level can interfere with many of the bodily systems, leading to blindness and death.

Why Has It Become Such a Problem Today?

In the past, islanders did not seem to suffer from a high diabetes rate even though their body was capable of storing sugar for a long period of time. In fact, the current theory is that Micronesians and other Pacific islanders could retain body sugar much longer than people from other places. This was an advantage for people who had to sustain themselves through periods when food was scarce–for instance, when seawater ruined taro patches or typhoons damaged the breadfruit supply on an island. In those days people had to store blood sugar in times of plenty so that they could depend on this source of energy when food was short.

Today, however, times of famine are rare or non-existent. Food is abundant, especially the store-bought food that is becoming an ever larger part of most people's diet. Some of this food is filled with fat and is less nourishing than traditional foods were. Besides, people are eating more of it than they were in the past. As a result, many people are becoming overweight, while their system is as slow in getting rid of blood sugar as it was in the past when diet was limited. Moreover, many islanders are not engaging in the physical activity that their ancestors did as a normal part of their daily life. In this age of automobiles and outboard engines, people do not do the walking or paddling they once did. Building a house and gathering food and preparing meals is much easier and requires much less physical exertion than in the past. The result is a sharp increase in the incidence of diabetes.

Two children visit their favorite storyteller, Lima, who tells the children the story of Uab and how the islands of Palau were formed. Through the telling of this story the children become aware of the connections between Uab and their friend Lima. Both are "giants" because of eating too much. After a trip to the doctor's office, the children learn that overeating can cause diabetes and that diabetes can lead to death. The myth of Uab ends with his destruction. How will Lima's story end?

Two middle aged men, good friends, learn that they both have diabetes. One postpones indefinitely the diet and exercise that his doctor advises for him, while the other resolves to do something about the disease. One begins eating local food and jogging. His friend, however, remains a prodigious overeater and as sedentary as ever. This video presents a dramatization of the lifestyle changes that are needed to cope with diabetes, and the difficulties that these changes involve.